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Simple summary of health care
Tweet Topic Started: Jun 18 2009, 01:26 PM (822 Views)
Mr Gray Jun 23 2009, 03:03 PM Post #31
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eelbor
Jun 23 2009, 08:14 AM
aaronk2727
Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
Sure, my premium goes up every year, however that is under the current state where they aren't required to carry certain drugs that are very expensive or have changed the classification of them to keep costs low. If they were forced to cover all FDA products/services, your premium would skyrocket.

The nanny state mentality necessary to accept such a law isn't worth any amount of insurance premium savings.
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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eelbor Jun 23 2009, 03:56 PM Post #32
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Jun 23 2009, 12:01 PM
My personal opinion is just that there should be a grandfather clause. If an insurance company wants to change the services/products they provide, that's fine except for clients that have already made claims against these products. If I've had cancer for 2 years, and my current medicine was covered, then it should continue to be covered as long as I keep paying my premiums. In this way, it helps protect those who would be denied due to pre-existing conditions. Those who do not currently have a condition should read the fine print and decide what insurance company provides the most options for their dollar like any other business.
2nd
A large portion of Americans are uninsurable outside of a group policy at work. If for whatever reason I were to lose my ability to work at the same time my wife did, there is not an insurance company around that would pick up my family. It is not a question of money. Health Insurance companies were originally around to spread the risk of catastrophic health care costs. Somewhere along the way this changed. It is now impossible to obtain an insurance policy unless you are in near perfect health.

I have a close friend who noticed their child had a growth disorder at the age of 6 months. The baby was put on hormones that he would need to take until the end of puberty. The monthly cost of these drugs was in excess of $30,000. Now, assume you are this person and you lose your job. You have 18 months of COBRA to find a new job with a decent health care plan, or the other alternative is unthinkable. If the health care plan at the job you are offered does not cover the drugs you need, you can not take the job. Trying to find out if the companies plan covers a $30k a month drug is going to be detrimental to your job hunting efforts regardless of any laws against that sort of discrimination. I have another friend with two daughters that have CF. He is in the same situation. If they can not be on a group policy, their families are uninsurable.

Insurance companies should not be allowed to decide what should be covered in medically necessary cases. If the FDA has approved a drug for treatment of your disease, it should be covered by every health care policy with prescription benefits. I do not want accountants deciding if I am worth the extra $875 dollars a month it takes to keep me alive.



Posted Image

"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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eelbor Jun 23 2009, 04:11 PM Post #33
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eelbor
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aaronk2727
Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
Sure, my premium goes up every year, however that is under the current state where they aren't required to carry certain drugs that are very expensive or have changed the classification of them to keep costs low. If they were forced to cover all FDA products/services, your premium would skyrocket.

The nanny state mentality necessary to accept such a law isn't worth any amount of insurance premium savings.
You are correct. Much better to make them into a little Soylent Green and be done with it.

You want to abandon abandon people to the system that exists now. But it is not saving you a dime. In the current system you pay their health care, just as I do. Uninsured people people use the emergency room as their primary care facility, and can not pay the bill. This money is passed back on to the insurance companies and to you in your taxes.

You spoke earlier of having some good ideas to transform health care. Were you going to get to those, or keep them to yourself?
Posted Image

"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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yawnzzz Jun 23 2009, 04:43 PM Post #34
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Insurance companies should not be allowed to decide what should be covered in medically necessary cases. If the FDA has approved a drug for treatment of your disease, it should be covered by every health care policy with prescription benefits. I do not want accountants deciding if I am worth the extra $875 dollars a month it takes to keep me alive.
Insurance companies being able to choose medication that they'll cover is the only thing keeping prescription drug companies somewhat reasonable in their cost. There's a drug for Hunter Syndrome that costs $300,000 per patient per year. Imagine if a drug like that came out for cancer. Insurance companies would be bankrupt in a day because everyone would want that one treatment instead of the thousands of other treatments that are a 1/10th of that cost.

Then on top of that, you get into the question of what is a 'medically necessary' case. The FDA just approves drugs that work, so are you going to leave that up to the insurance company still? If so, then expect to see a ton of certain conditions dropped from being 'medically necessary' to cover the cost of the above.

Truthfully, you might as well make the government the complete administrator of health insurance if you want to take it this far because in your scenario the middleman insurance companies are completely reliant on the government. They fail or succeed based on the FDA, so you might as well take the profit from lucky insurance companies and use it to pay the debt of the unlucky insurance companies because in the end, the government's going to have to cover that cost when they file bankruptcy, so they might as well at least get the profit side as well.
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Mr Gray Jun 23 2009, 09:27 PM Post #35
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Jun 23 2009, 03:56 PM
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Jun 23 2009, 03:00 PM
yawnzzz
Jun 23 2009, 12:01 PM
My personal opinion is just that there should be a grandfather clause. If an insurance company wants to change the services/products they provide, that's fine except for clients that have already made claims against these products. If I've had cancer for 2 years, and my current medicine was covered, then it should continue to be covered as long as I keep paying my premiums. In this way, it helps protect those who would be denied due to pre-existing conditions. Those who do not currently have a condition should read the fine print and decide what insurance company provides the most options for their dollar like any other business.
2nd
A large portion of Americans are uninsurable outside of a group policy at work. If for whatever reason I were to lose my ability to work at the same time my wife did, there is not an insurance company around that would pick up my family. It is not a question of money. Health Insurance companies were originally around to spread the risk of catastrophic health care costs. Somewhere along the way this changed. It is now impossible to obtain an insurance policy unless you are in near perfect health.

I have a close friend who noticed their child had a growth disorder at the age of 6 months. The baby was put on hormones that he would need to take until the end of puberty. The monthly cost of these drugs was in excess of $30,000. Now, assume you are this person and you lose your job. You have 18 months of COBRA to find a new job with a decent health care plan, or the other alternative is unthinkable. If the health care plan at the job you are offered does not cover the drugs you need, you can not take the job. Trying to find out if the companies plan covers a $30k a month drug is going to be detrimental to your job hunting efforts regardless of any laws against that sort of discrimination. I have another friend with two daughters that have CF. He is in the same situation. If they can not be on a group policy, their families are uninsurable.

Insurance companies should not be allowed to decide what should be covered in medically necessary cases. If the FDA has approved a drug for treatment of your disease, it should be covered by every health care policy with prescription benefits. I do not want accountants deciding if I am worth the extra $875 dollars a month it takes to keep me alive.



eel, what you are saying is that you want the government to force a private company to pay $30,000 per month for drugs on a policy that earns them $2,000 per month (or whatever it is....mine is much less than that), meaning you want the government to force the insurance company to lose $28,000 per month. I'll let you figure out what will happen if you do that, but please rethink your logic here, because that is a really really bad idea.
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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Mr Gray Jun 23 2009, 09:31 PM Post #36
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You spoke earlier of having some good ideas to transform health care. Were you going to get to those, or keep them to yourself?
I'll get to them, but right now your line of thinking is so far off from mine, it would just derail a pretty good conversation so far.
Posted Image
The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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IUCOLTFAN Jun 23 2009, 10:42 PM Post #37
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Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
How is it fair that my employer pays 2/3 of my insurance, I pay 1/3 and then get taxed on it to pay for "yours" ??? Regardless if my premiums rise every year, I am still forced to pay for "yours" . So with this plan, if my premiums get lower (as you claim) and my taxes get higher, how does this help me?

Bottom line.....50% of the population cant pay 100% of the bills........the math just doesnt work. You'll be rich or you'll be poor, there will be no middle class and the poor will still be poor.......end of story.

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eelbor Jun 24 2009, 08:12 AM Post #38
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Jun 23 2009, 09:27 PM
eelbor
Jun 23 2009, 03:56 PM
aaronk2727
Jun 23 2009, 03:00 PM
yawnzzz
Jun 23 2009, 12:01 PM
My personal opinion is just that there should be a grandfather clause. If an insurance company wants to change the services/products they provide, that's fine except for clients that have already made claims against these products. If I've had cancer for 2 years, and my current medicine was covered, then it should continue to be covered as long as I keep paying my premiums. In this way, it helps protect those who would be denied due to pre-existing conditions. Those who do not currently have a condition should read the fine print and decide what insurance company provides the most options for their dollar like any other business.
2nd
A large portion of Americans are uninsurable outside of a group policy at work. If for whatever reason I were to lose my ability to work at the same time my wife did, there is not an insurance company around that would pick up my family. It is not a question of money. Health Insurance companies were originally around to spread the risk of catastrophic health care costs. Somewhere along the way this changed. It is now impossible to obtain an insurance policy unless you are in near perfect health.

I have a close friend who noticed their child had a growth disorder at the age of 6 months. The baby was put on hormones that he would need to take until the end of puberty. The monthly cost of these drugs was in excess of $30,000. Now, assume you are this person and you lose your job. You have 18 months of COBRA to find a new job with a decent health care plan, or the other alternative is unthinkable. If the health care plan at the job you are offered does not cover the drugs you need, you can not take the job. Trying to find out if the companies plan covers a $30k a month drug is going to be detrimental to your job hunting efforts regardless of any laws against that sort of discrimination. I have another friend with two daughters that have CF. He is in the same situation. If they can not be on a group policy, their families are uninsurable.

Insurance companies should not be allowed to decide what should be covered in medically necessary cases. If the FDA has approved a drug for treatment of your disease, it should be covered by every health care policy with prescription benefits. I do not want accountants deciding if I am worth the extra $875 dollars a month it takes to keep me alive.



eel, what you are saying is that you want the government to force a private company to pay $30,000 per month for drugs on a policy that earns them $2,000 per month (or whatever it is....mine is much less than that), meaning you want the government to force the insurance company to lose $28,000 per month. I'll let you figure out what will happen if you do that, but please rethink your logic here, because that is a really really bad idea.
Not everyone is going to have a $30k a month drug charge. You do realize this is a exceedingly rare condition. If we are going to charge people exactly what their medicines cost, outside of having insurance, then eliminate insurance companies altogether. As I have tried to explain Insurance is there to spread the risk. If you have X amount of people in perfect health that do not use their benefit, that money is left to offset the loses on patients like my good friend's daughter.

Yawnnz made a much better point about what would happen if they came up with a medical treatment for cancer that cost $200k annually. Cancer is by no means rare, and that could have a serious impact on insurance coffers. I believe that doctors should be making the medical decisions in these cases, not accountants, but most doctors I know need a few courses in cost/benefit analysis.

With the current system, insurance companies want to avoid paying for preventitive care. I have said before I have a diabetic child. Our insurancce company denied our initial claim for real-time blood glucose sensors. Instead they wanted her to continue to use finger stick blood glucose checks. The real time sensors annual cost about the same as one trip to the emergency room in an ambulance, plus they are much better at predicting trends in her blood glucose. She has had three trips in the last 4 years to the emergency room for low blood glucose before the sensors.) Since she has started the sensors she has had zero trips to the hospital. These sensors allow for the blood glucose levels to be treated before they become an issue. Better control means better long term health and fewer complications. Amputations and blindness are both very real prospects to diabetics with poor blood glucose level control. Now, the insurance company will pay for amputations, but they balk at covering the cost of preventing the amputation now before the circulatory system damage is done. Why? Because if my child ever needs an amputation, it will be several years in the future when she will more than likely be on another insurance companies policy.
Posted Image

"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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eelbor Jun 24 2009, 08:25 AM Post #39
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Jun 23 2009, 10:42 PM
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Jun 23 2009, 08:14 AM
aaronk2727
Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
How is it fair that my employer pays 2/3 of my insurance, I pay 1/3 and then get taxed on it to pay for "yours" ??? Regardless if my premiums rise every year, I am still forced to pay for "yours" . So with this plan, if my premiums get lower (as you claim) and my taxes get higher, how does this help me?

Bottom line.....50% of the population cant pay 100% of the bills........the math just doesnt work. You'll be rich or you'll be poor, there will be no middle class and the poor will still be poor.......end of story.

Well, currently a portion of your taxes pay for a large portion of unreimbursed indigent health care. That cost would be eliminated.

Medical costs would lower. A hospital has to bring in as much money as it spends or it closes,.. simple economics (unless you are a Detroit automaker, then you get bailout money, but that is another topic). If 30% of the care you provide is unreimbursed you must either pass this cost unto your other patients, the government, or a combination thereof. Hospitals do the final thing; they pass what they can to the government and raise rates on services across the board to make up the rest. Health care costs per procedure would drop if every procedure was paid for.

The gorilla in the room everyone keeps ignoring is that you are already paying for these people's healthcare.
Posted Image

"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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IUCOLTFAN Jun 24 2009, 05:44 PM Post #40
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Jun 24 2009, 08:25 AM
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Jun 23 2009, 10:42 PM
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Jun 23 2009, 08:14 AM
aaronk2727
Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
How is it fair that my employer pays 2/3 of my insurance, I pay 1/3 and then get taxed on it to pay for "yours" ??? Regardless if my premiums rise every year, I am still forced to pay for "yours" . So with this plan, if my premiums get lower (as you claim) and my taxes get higher, how does this help me?

Bottom line.....50% of the population cant pay 100% of the bills........the math just doesnt work. You'll be rich or you'll be poor, there will be no middle class and the poor will still be poor.......end of story.

Well, currently a portion of your taxes pay for a large portion of unreimbursed indigent health care. That cost would be eliminated.

Medical costs would lower. A hospital has to bring in as much money as it spends or it closes,.. simple economics (unless you are a Detroit automaker, then you get bailout money, but that is another topic). If 30% of the care you provide is unreimbursed you must either pass this cost unto your other patients, the government, or a combination thereof. Hospitals do the final thing; they pass what they can to the government and raise rates on services across the board to make up the rest. Health care costs per procedure would drop if every procedure was paid for.

The gorilla in the room everyone keeps ignoring is that you are already paying for these people's healthcare.
The last line of your post is exactly my point. How does this change help me. Government overpays for everything, now somehow government controlled healthcare will lower the cost? So adding a gazillion more federal employees to run this dept, paying their healthcare benefits, vacations, holidays, sick days, etc..........this is going to lower health cost? Maybe the cost of your actual services (and I'm yet to see ANY solid data that would prove this......its all conjecture), but not when you add the cost of the fraud, waste, or skimming off the top that goes on in EVERY government dept.

Its a pipe dream. The CBO says for 1.6 trillion we can insure 16 million americans (not all uninsured americans)..........thats SALTY! The math doesnt make sense........it wont work. It will go down as Obama's biggest fuck up.
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eelbor Jun 24 2009, 06:01 PM Post #41
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Its a pipe dream. The CBO says for 1.6 trillion we can insure 16 million americans (not all uninsured americans)..........thats SALTY! The math doesnt make sense........it wont work. It will go down as Obama's biggest fuck up.
Maybe. He is barely out of his first 100 days.
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"Liberal, shmiberal. That should be a new word. Shmiberal: one who is assumed liberal, just because he's a professional whiner in the newspaper. If you'll read the subtext for many of those old strips, you'll find the heart of an old-fashioned Libertarian. And I'd be a Libertarian, if they weren't all a bunch of tax-dodging professional whiners." - Berkeley Breathed


Meat is Murder. Sweet, delicious murder.
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HoosierLars Jun 24 2009, 06:09 PM Post #42
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Its a pipe dream. The CBO says for 1.6 trillion we can insure 16 million americans (not all uninsured americans)..........thats SALTY! The math doesnt make sense........it wont work. It will go down as Obama's biggest fuck up.
Maybe. He is barely out of his first 100 days.
Right, I was thinking I would need to make a list before choosing the biggest one.
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Mr Gray Jun 24 2009, 10:00 PM Post #43
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The gorilla in the room everyone keeps ignoring is that you are already paying for these people's healthcare.
I am not ignoring that gorilla. I don't believe we should be paying for that either. Your solution is to assume that 2 wrongs make a right, and I would rather make it right to begin with.

When you reference insurance companies "spreading the risk" of catastrophe, you are correct, but when their costs are increasing astronomically year after year, they have no choice but to limit new members to those in good health in order to try to keep the premiums for their existing customer "reasonable".

Look eel, I have tons of compassion for those with medical problems, and as I have posted on here a few months ago, I am going through a major medical problem in my family as we speak. The problem is, however, that medical problems are expensive and someone has to pay for them. If we force insurance companies to cover more services via government mandate, they will either raise rates to unaffordable levels so less people can afford insurance, go out of business so nobody is covered, or go to the government for help, resulting in even more taxes and wealth redistribution.

I know you think church isn't the answer to anything, but at my church we have helped hundreds of people afford medical attention and also helped them get a more affordable price for the service. We are much better at it than the government, but just like everything that has a cost attached to it...someone has to pay for it.
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The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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brumdog44 Jun 25 2009, 04:47 PM Post #44
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Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
No kidding. You weren't serious on this question, were you aaron? Our blue anthem rates continually raise at near double digit percentages.
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Mr Gray Jun 25 2009, 09:16 PM Post #45
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Jun 22 2009, 10:43 PM
so if that newly approved drug is covered, which causes your premium to go up considerably at next contract date (the drug is expensive and no generics available yet), you are OK with that?
They already do this. I am sure your insurance premiums rise annually just like mine do. I know it is a hugely unpopular idea, but if there were a law that required adults to carry insurance, the price of health care (per visit) in the US would shrink, as would your insurance premiums. Right now all the uncompensated heathcare provided to the nation's indigent population is being passed back on to taxpayers and your insurance premiums.
No kidding. You weren't serious on this question, were you aaron? Our blue anthem rates continually raise at near double digit percentages.
brum, under this scenario, the annual increases would dwarf those of today's environment IMO. they would have to in order to absorb those costs.
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The body knows what fighters don't: how to protect itself. A neck can only twist so far. Twist it just a hair more and the body says, "Hey, I'll take it from here because you obviously don't know what you're doing... Lie down now, rest, and we'll talk about this when you regain your senses." It's called the knockout mechanism.
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